Hipospadia peniana em cão ­ Relato de caso / Penile hypospadias in a dog - Case report / Hipospadias peneana en un perro ­ Reporte de caso

A hipospadia é oresultado de falha no desenvolvimento em que não ocorre a fusão normal das dobras genitais e intumescência genital, o que causa desenvolvimento anormal da uretra peniana, do pênis, prepúcio e/ou escroto. O objetivodeste relato é descrever um caso de hipospadia peniana de um canino macho, sem raça definida (SRD), de oito meses deidade, atendido no Hospital Veterinário da Universidade Federal Rural da Amazônia, na cidade de Belém/Pará, detalhando os procedimentos cirúrgico e anestésico utilizados para resolução do caso. Ao chegar ao hospital, o animal foi submetido ao exame físicoinicial no qual observou-se uma deformidade na região perianal por onde drenava a urina e uma abertura na região prepucial. A partir disso, foi solicitada a uretrocistografia retrógrada para complemento diagnóstico da hipospadia e seu comprometimento ao sistema urinário interno. Diante disso, foi realizado procedimento cirúrgico reconstrutivo e orquiectomia terapêutica, alcançando permitindoa resolução do caso e a recuperação completa do animal. Considerando que essa deformidade impossibilita a capacidadesexual generandi, a resolução recomendada é a cirúrgica, na qual o prognóstico é bom, possibilitando qualidade de vida ao animal.(AU)

Hypospadias is the result of developmental failure where normal fusion of the genital folds and genital tumescence does not occur, which causes abnormal development of the penile urethra, penis, foreskin and/or scrotum. The objective of this report is to describe a case of penile hypospadias in an eight-month-old male mixed breed (SRD) canine, treated at the Veterinary Hospital of the Federal Rural University of Amazônia, in the city of Belém/Pará, detailing the procedures surgical and anesthetic used for resolution of the case. Upon arrival at the hospital, the animal underwent an initial physical examination in which a deformity was observed in the perianal region through which urine drained and an opening in the preputial region. From this, a retrograde urethrocystography was requested to complement the diagnosis of hypospadias and its commitment to the internal urinary system. In view of this, a reconstructive surgical procedure and therapeutic orchiectomy were performed, allowing the resolution of the case and the complete recovery of the animal. Considering that this deformity prevents the sexual capacity generandi, the recommended resolution is surgery, in which the prognosis is good, allowing quality of life for the animal.(AU)

La hipospadias es el resultado de una falla en el desarrollo donde no ocurre la fusión normal de los pliegues genitales y la tumescencia genital, lo que provoca un desarrollo anormal de la uretra peneana, el pene, el prepucio y/o el escroto. El objetivo de este relato es describir un caso de hipospadias peneana en un canino macho mestizo (SRD) de ocho meses de edad, atendido en el Hospital Veterinario de la Universidad Federal Rural de Amazônia, en la ciudad de Belém/Pará, detallando los procedimientos quirúrgicos y anestésicos utilizados para la resolución del caso. A su llegada al hospital, el animal fue sometido a un examen físico inicial en el que se observó una deformidad en la región perianal por donde salía la orina y una abertura en la región prepucial. A partir de ello se solicitó cistouretrografía retrógrada para complementar el diagnóstico de hipospadias y su afectación en el sistema urinario interno. Ante esto, se realizó un procedimiento quirúrgico reconstructivo y orquiectomía terapéutica, que permitió la resolución del caso y la recuperación completa del animal. Teniendo en cuenta que esta deformidad imposibilita la capacidadgeneradi sexual, la resolución recomendada es la cirugía, en la que el pronóstico es bueno, permitiendo calidad de vida para el animal.(AU)

Hypospadias in two cats: case report / Hipospadia em dois gatos: relato de caso

Hypospadias is an uncommon sexual development disorder in cats, in which the urethral opening is not in its anatomical location on the penis. The purpose of this report is to describe two cases of hypospadias in the feline species. The first cat was asymptomatic, had a history of bacterial cystitis, and was diagnosed with perineal hypospadias at an appointment for preoperative evaluation of orchiectomy. The second cat had clinical signs of dysuria and pollakiuria for 30 days and had glandular hypospadias. Both cats showed abnormalities in the urinalysis which were suggestive of lower urinary tract disease. For both cases, clinical treatment with antibiotic therapy was performed. In the first patient, surgical treatment consisted of orchiectomy, while in the second animal a perineal urethrostomy and orchiectomy were performed. The cats had a satisfactory recovery after the treatments. Performing a thorough physical examination is essential to diagnose cases of hypospadias and choose the best treatment for each patient.

A hipospadia é uma desordem do desenvolvimento sexual pouco comum nos gatos, na qual a abertura uretral não está em sua localização anatômica do pênis. O objetivo do presente relato é descrever dois casos de hipospadia em felinos domésticos. O primeiro gato era assintomático, tinha histórico de cistite bacteriana prévio, e foi diagnosticado com hipospadia perineal em uma consulta para avaliação pré-cirúrgica de orquiectomia. O segundo gato apresentava sinais clínicos de disúria e polaquiúria há 30 dias e apresentava hipospadia glandular. A partir dos exames complementares, pôde-se observar que os animais, além do defeito anatômico, apresentavam alterações sugestivas de doença do trato urinário inferior. Para ambos os casos, foi realizado o tratamento clínico inicial com antibioticoterapia. No primeiro paciente, optou-se pelo procedimento de orquiectomia, enquanto no segundo animal foram realizadas as técnicas de uretrostomia perineal e orquiectomia. Os gatos mostraram recuperação satisfatória após os tratamentos instituídos. Dessa forma, pode-se observar a importância de se realizar um exame físico minucioso a fim de diagnosticar os casos de hipospadia e escolher o tratamento correto para cada paciente.

Prolapso uretral em um cão da raça American Bully / Urethral prolapse in a dog of the American Bully breed

O prolapso uretral, o qual é incomum em cães, se caracteriza pela protusão da mucosa uretral além da extremidade do pênis e do orifício externo da uretra. Pode ocorrer por causas congênitas ou adquiridas, tendo maior incidência em animais jovens não castrados. O objetivo do presente trabalho é relatar um caso de prolapso uretral em um cão não castrado da raça American Bully Terrier, de dois anos, o qual foi atendido na Universidade Estácio de Sá localizada no Rio de Janeiro com histórico de lambedura excessiva do pênis, disúria, sangramento prepucial e protrusão da mucosa uretral após tentativa de cópula. Durante a avaliação física o animal apresentou todos os parâmetros clínicos dentro da normalidade, entretanto demonstrava agitação excessiva e dor na região afetada. Então, o diagnóstico foi definido por meio da inspeção direta da visualização da mucosa uretral protusa. Frente ao quadro clínico e físico do animal, foi adotado o procedimento cirúrgico de ressecção e anastomose da porção uretral prolapsada. Desta forma, conclui-se que esta técnica cirúrgica se mostrou eficaz, visto que o referido paciente apresentou ótima recuperação e cicatrização uretral, sem quaisquer sinais de complicações pós-cirúrgicas.

Urethral prolapse, which is uncommon in dogs, is characterized by protrusion of the urethral mucosa beyond the tip of the penis and the external orifice of the urethra. It can occur due to congenital or acquired causes, with a higher incidence in young animals not castrated. The present study aims to report a case of urethral prolapse in a non-castrated dog of 2 years old (American Bully Terrier), which was treated at the Estácio de Sá University located in Rio de Janeiro city, with a history of excessive penis licking, dysuria, prepucial bleeding, and protrusion of the urethral mucosa after an attempt of copulation. During the physical evaluation, the animal presented all clinical parameters within the normal range; however, it showed excessive agitation and pain in the affected region. Then, the diagnosis was defined through direct inspection of the visualization of the protruding urethral mucosa. Given the animal's clinical and physical condition, the surgical procedure of resection and anastomosis of the prolapsed urethral portion was adopted. Therefore, it is concluded that this surgical technique proved to be effective since the patient presented excellent recovery and urethral healing, without any signs of post-surgical complications.

Carcinoma uretral primário em uma cadela - tratamento multimodal / Primary urethral carcinoma in a bitch - multimodal treatment

Background: Urethral tumors are uncommon in canines, represented predominantly by transitional cell carcinoma, marked by aggressive behavior associated with short life expectancy. Definitive diagnosis is achieved by histopathological analysis. Surgery associated with chemotherapy is the main therapeutic alternative. The aim of this paper is to report a case of primary transitional cell carcinoma of the urethra in a bitch, submitted to surgical treatment associated with conventional adjuvant chemotherapy and metronomic chemotherapy, achieving survival of 21 months, to date. Case: A 12-year-old bitch mixed breed was admitted at the Veterinary Hospital of Federal Rural University of Rio de Janeiro (UFRRJ), manifesting hematuria and urinary incontinence for one month. Physical examination indicated that vital parameters were within normal limits. Laboratory tests of blood count and serum biochemistry, urinalysis, culture, urinary antibiogram, and abdominal ultrasound were performed. The ultrasound image suggested a neoplastic urethral process. Because of the suspicion of neoplasm, a thoracic X-ray was performed, showing no evidence of metastasis. Computed tomography (CT) of the abdominal region was performed, revealing an expansive lesion in the urethra with loss of definition of the walls and urethral lumen extending to the level of the pelvic floor, measuring about 2.9 x 1.4 x 1.2 cm. After preanesthetic exams, the animal underwent resection and surgical anastomosis of the affected urethral region. The sectioned tissue was sent for histopathological analysis, with diagnosis of transitional cell carcinoma. Adjuvant chemotherapy was performed using carboplatin at a dose of 250 mg/m², intravenously, every 21 days for 6 sessions. After completing the protocol, abdominal ultrasonography was performed again, which showed a cicatricial process in the urethral region of the surgical excision, with no sign of tumor recurrence. A metronomic chemotherapy protocol was then started with cyclophosphamide at a dose of 15 mg/m², daily for 6 months, with periodic oncological follow-up. At the end of the period, the animal remained under periodic follow-up with ultrasound exams performed at 2-month intervals, and has been free from recurrence for 21 months until now. Discussion: Urethral neoplasms account for 0.5 - 2% of all canine tumors, and are represented mostly by transitional cell carcinomas. Clinical signs of urinary obstruction and hematuria are the most common, as reported in the patient in question. The definitive diagnosis is by histopathological examination. However, imaging tests such as computed tomography are important in the initial investigation and surgical planning. The indicated treatment is surgical resection of the mass with subsequent adjuvant chemotherapy or radiotherapy. The chemotherapy protocol associating cisplatin and piroxicam can achieve remission rates of 70%, but this association has a high nephrotoxic effect. In the present case, cisplatin was replaced by carboplatin in order to reduce the nephrotoxic effects of chemotherapy. The metronomic protocol using cyclophosphamide was used as maintenance therapy, at the end of the conventional chemotherapy protocol. Survival achieved was longer than that described in the literature in cases of transitional cell carcinomas in the urethral region. Therefore, multimodal therapy using surgery associated with conventional and metronomic chemotherapy, is an option in canines with urethral carcinoma.

Urethral reconstruction combined with modified urethrostomy in a cat after prepubic urethrostomy

Background: In cats, urethral obstruction is generally caused by various reasons, including feline idiopathic cystitis, urethral crystals, urethral trauma, mucous plug, congenital or acquired anatomical deformity, and urolithiasis, especially in male cats. Depending on the severity and duration of clinical signs, immediate management including conservative or surgical therapy for restoration of urethral patency is required. Repetitive urethral obstruction due to intraluminal plugs, obstruction that cannot be resolved by medical management, and urethral strictures, trauma, or neoplasia should be managed by surgery. When the penile or pelvic urethra is ruptured or not long enough to mobilize the pelvic urethra to the perineal skin by repetitive perineal urethrostomy, prepubic urethrostomy is indicated. Potential complications of prepubic urethrostomy include urinary incontinence, peristomal dermatitis. In such cases, management of the peristomal site or placement of an artificial urethral sphincter have been reported previously. However, to date, urethral reconstruction using pre-existing penis has not been reported after prepubic urethral stricture following prepubic urethrostomy. The objective of this report is to describe surgical procedure of the urethral reconstruction combined with modified perineal urethrostomy in a cat with prepubic urethral stricture after prepubic urethrosotmy. Case: A 3-year-old castrated Scottish straight cat presented with dysuria after prepubic urethrostomy. The owner reported that the patient was diagnosed with urethral rupture, had undergone prepubic urethrostomy 2 months prior to presentation, and had persistent dysuria despite repetitive surgical revision of the prepubic urethral stoma at a local hospital. On physical examination, the preputial orifice and the penis appeared grossly normal. On ultrasonography, pericystic and periurethral fat had an edematous, striated appearance with alternating hyperechoic and anechoic regions. A small amount of free fluid was visible around the urethra. Abdominal radiography revealed a mildly distended bladder and loss of serosal detail around the area of the urinary bladder neck, consistent with inflammation and free fluid observed on ultrasonography. The retrograde urethrogram showed no leakage in either sites of the prepubic urethral orifice or the penis. Hence, complete urethral reconstruction with modified perineal urethrostomy was performed. The patient had normal urination at the 15-month follow-up. Discussion: Prepubic urethrostomy is beneficial for the patients whose penile or pelvic urethra is ruptured or not long enough to mobilize the pelvic urethra to the perineum. Complications of prepubic urethrostomy include skin necrosis around the stoma; urinary incontinence; stricture of the urethral stoma due to several reasons such as surgical-site irritation; poor mucosa-skin apposition; failure to provide tension-free stoma; and failure to expose wider pelvic urethra. In these cases, surgical management of the level of prepubic urethral stoma has been recommended by previous studies. However, no studies have been reported urethral reconstruction using pre-existing penile urethra in a patient with prepubic urethral stricture so far. To the author's knowledge, this case is the first report describing urethral reconstruction in a cat with urethral stricture after prepubic urethrostomy.

Avaliação andrológica no garanhão: ênfase no exame interno do sistema genital / Breeding soundness examination in stallions: emphasis on internal assessment of the genital system

A avaliação do sistema genital interno no garanhão é uma importante etapa do exame andrológico, mas ainda é negligenciada na clínica reprodutiva dessa espécie. A maioria das enfermidades que acometem as glândulas sexuais acessórias e a uretra são descritas na literatura como pouco frequentes e até mesmo raras, no entanto a falta de diagnóstico, em muitos casos, contribui para essa estatística. Dentre as enfermidades mais recorrentes se destacam a vesiculite seminal, obstrução de ampola e fistula uretral que podem levar a prejuízos na qualidade seminal e baixa fertilidade. Dessa forma, o objetivo desta revisão é abordar as principais ferramentas de avaliação dos órgãos genitais internos nos machos equinos, visando contribuir para o correto diagnóstico e tratamento das principais afecções que os acometem.(AU)

The evaluation of the internal genital system in stallions is an important step in the breeding soundness exam that is still neglected in the reproductive clinic of this species. Most diseases that affect the accessory sex glands and the urethra are described in the literature as infrequent and even rare, however the lack of diagnosis, in many cases, contributes to this statistic. Among the most recurrent diseases are seminal vesiculitis, plugged ampullae and urethral rent that can lead to decreased seminal quality and low fertility. Thus, the objective of this review is to highlight the main tools for evaluating the internal genitalia in stallions, aiming to contribute to the diagnosis and treatment of the main conditions that affect them.(AU)

Prevalence and risk factors for urinary incontinence in bitches five years after ovariohysterectomy / [Prevalência e fatores de risco para incontinência urinária em cadelas cinco anos após ovário histerectomia]

Ovariohysterectomy (OHE) is the most performed elective surgery in veterinary medicine. Although this procedure brings benefits both to the animal and public health, acquired urinary incontinence is a possible complication resultant from it. The aim of this study was to determine the prevalence of urinary incontinence and evaluate size, breed, and time of surgery as risk factors in a population of spayed female dogs in the Hospital de Clínicas Veterinárias da Universidade Federal do Rio Grande do Sul, in the year of 2013, through the use of a multiple-choice screening instrument. Identified estimated prevalence was 11.27% and main risk factors were as follows: large size (OR = 7.12 IC95% = 1.42 - 35.67), Rottweiler breed (OR = 8.92; IC95% = 5.25 - 15.15), Pit-bull breed (OR = 4.14; IC95% = 2.19 - 7.83), and Labrador breed (OR = 2.73; IC95% = 1.53 - 4.87). Time of surgery was not considered a risk factor for urinary incontinence in this population (OR = 1.45; IC95% = 0.86 - 2.40). Even though most owners reported a small impact on their relationship with the animal, urinary incontinence hazard should be addressed before spaying.(AU)

A ovário-histerectomia (OHE) é a cirurgia eletiva mais realizada em medicina veterinária. Embora seja um procedimento que beneficie a saúde pública e do animal, a incontinência urinária adquirida é uma complicação possível resultante desse procedimento. O objetivo deste estudo foi determinar a prevalência de incontinência urinária e avaliar porte, raça e momento da castração como fatores de risco em uma população de cadelas castradas no HCV/UFRGS, no ano de 2013, através do uso de um instrumento de triagem de múltipla escolha. A prevalência estimada foi de 11,27% e os principais fatores de risco foram: grande porte (OR = 7,12 IC95% = 1,42 - 35,67), raça Rottweiler (OR = 8,92; IC95% = 5,25 - 15,15), raça Pitbull (OR = 4,14; IC95% = 2,19 - 7,83) e raça Labrador (OR = 2,73; IC95% = 1,53 - 4,87). O tempo da cirurgia não foi considerado fator de risco para incontinência urinária nessa população (OR = 1,45; IC95% = 0,86 - 2,40). Embora a maioria dos proprietários tenha relatado um pequeno impacto no relacionamento com o animal, a possibilidade de incontinência urinária deve ser devidamente discutida antes da castração.(AU)

Obstructive urethrolithiasis in a mule

Background: Obstructive urolithiasis is a rare but potentially serious condition in equids. In the reviewed literature, there are several case reports of urolithiasis in horses and donkeys, but the only mention of this condition in mules occurred as incidental findings at a slaughterhouse. Therefore, this work aims to describe the first report and successful treatment of obstructive urethrolithiasis in a mule (Equus asinus x Equus caballus). Case: A 10-year-old castrated male mule weighing 380 kg was referred for hospital care. Tachycardia (64 beats per min), mild dehydration (7%), increased capillary filling time (3 s), slightly congested mucous membranes, and dysuria were observed. During its attempts to urinate, the mule was able to expose the penis, resulting in only dribbling of urine with reddish coloration. Urethral catheterization failed to reach the urinary bladder and revealed an obstruction at the ischial arch (7 x 4 cm), as confirmed by palpation and ultrasonography. Additionally, rectal ultrasound examination showed urine sedimentation and a single 2.36 mm vesical calculus. After sedation, local anesthesia, and surgical preparation, urethrotomy in the standing position was performed over the urethral obstruction at the ischial arch, reaching the urethrolith that fragmented during removal. Urethral catheterization from the urethrotomy site to flush the urinary bladder and urethra were performed, but the remaining vesical calculus was not retrieved. Considering the presence of a vesical calculus, severe urethral damage caused by the spiculated calculus and catheterization attempts, permanent perineal urethrostomy was performed. Laboratory tests revealed unremarkable hematological parameters, while serum biochemistry showed increased creatinine level. Urinalysis revealed cloudiness, amber appearance, countless red blood cells and bacteria, and calcium carbonate crystals. The urethrolith composition included ammonia, carbonate, and oxalate. Twelve months after surgery, the mule was healthy, the urethrostomy was viable, and no complications were recorded during this period. Discussion: Although uncommon, there are reports describing calculi of different sizes and weighing up to 803 g, causing mild to severe clinical signs according to the degree of obstruction in horses and donkeys. In the mule described here, the urethrolith did not completely obstruct the urethra, but the spiculated calculus caused dysuria and hematuria. In fact, most animals are usually referred for acute abdominal signs or hematuria and pollakiuria, but other unusual signs, such as rectal prolapse, may also be present. In the present report, the diagnosis of obstructive urethrolithiasis was established based on clinical signs and transcutaneous ultrasound of the subischial area, allowing visualization of the urethrolith. To the best of our knowledge, this is the first report of obstructive urethrolithiasis affecting a mule in Brazil. We reiterate that this condition must be included in the differential diagnosis of mules and hinnies with hematuria and dysuria, especially when associated with abdominal pain. Additionally, urethrostomy associated with urethrotomy performed on this mule in the standing position was a low-cost procedure with good results. Due to the lack of specificity regarding the food management of the mule on the previous farm, an assessment cannot be made regarding the effects of its food on urolith composition.(AU)

Post-neutering urethral sphincter mechanism incompetence in female dogs

Female dogs neutering is a routine surgery that aims to prevent diseases as well as to help populational control. Urinary incontinence is one of the most significant unwanted consequences following the procedure. Pharmacological treatment is recommended for such case, and alpha-adrenergic and estrogenic drugs have been the most frequent choices reported in literature. Besides, tricyclic antidepressants are also able to control clinical signs. The exact mechanism involved with this condition is not yet fully understood. Estrogen deficiency with a subsequent loss of urethral tonus is believed to trigger clinical signs. However, it is possible that other factors such as gonadotropins and gonadotropin-releasing hormone levels may play a part on this complex mechanism of the post-neutering urinary incontinence.(AU)

Post-neutering urethral sphincter mechanism incompetence in female dogs

Female dogs neutering is a routine surgery that aims to prevent diseases as well as to help populational control. Urinary incontinence is one of the most significant unwanted consequences following the procedure. Pharmacological treatment is recommended for such case, and alpha-adrenergic and estrogenic drugs have been the most frequent choices reported in literature. Besides, tricyclic antidepressants are also able to control clinical signs. The exact mechanism involved with this condition is not yet fully understood. Estrogen deficiency with a subsequent loss of urethral tonus is believed to trigger clinical signs. However, it is possible that other factors such as gonadotropins and gonadotropin-releasing hormone levels may play a part on this complex mechanism of the post-neutering urinary incontinence.

Surgical correction of bilateral ectopic ureter using the neoureterocystostomy technique / Correção cirúrgica de ureter ectópico bilateral utilizando a técnica de neoureterocistostomia

Ureteral ectopy is a rare disorder in the small animals' clinic. It is characterized as a congenital anomaly, resulting from the ducts differentiation failure during embryogenesis. In this scenario, the ureters present themselves outside the anatomical site, being inserted into the uterus, urethra, urinary vesicle neck, or vagina. The clinical signs are urinary incontinence and perivulvar dermatitis. Surgery is the accepted treatment to correct the anomaly. The surgical procedure is based on relocating the ectopic ureter and treating associated modifications. This report describes a case of intramural bilateral ureteral ectopy, corrected surgically through the neoureterocystostomy technique, making it possible to control the animal's urinary incontinence.(AU)

A ectopia ureteral é uma afecção de incidência rara na clínica de pequenos animais, sendo caracterizada como anomalia congênita resultante de falha na diferenciação dos ductos durante a embriogênese. Neste cenário, os ureteres se apresentam fora do seu local anatômico, sendo inseridos no útero, no colo da vesícula urinária, na uretra ou na vagina. Os sinais clínicos comumente apresentados são a incontinência urinária bem como a dermatite perivulvar. O tratamento de eleição para correção da anomalia é o procedimento cirúrgico, no qual a técnica de escolha é baseada na relocação do ureter ectópico e tratamento das alterações associadas. Neste contexto, o presente relato descreve um caso de ectopia ureteral bilateral intramural, corrigido cirurgicamente por meio da técnica neoureterocistostomia, o que possibilitou controle da incontinência urinária do paciente.(AU)

Surgical correction of bilateral ectopic ureter using the neoureterocystostomy technique / Correção cirúrgica de ureter ectópico bilateral utilizando a técnica de neoureterocistostomia

Ureteral ectopy is a rare disorder in the small animals' clinic. It is characterized as a congenital anomaly, resulting from the ducts differentiation failure during embryogenesis. In this scenario, the ureters present themselves outside the anatomical site, being inserted into the uterus, urethra, urinary vesicle neck, or vagina. The clinical signs are urinary incontinence and perivulvar dermatitis. Surgery is the accepted treatment to correct the anomaly. The surgical procedure is based on relocating the ectopic ureter and treating associated modifications. This report describes a case of intramural bilateral ureteral ectopy, corrected surgically through the neoureterocystostomy technique, making it possible to control the animal's urinary incontinence.(AU)

A ectopia ureteral é uma afecção de incidência rara na clínica de pequenos animais, sendo caracterizada como anomalia congênita resultante de falha na diferenciação dos ductos durante a embriogênese. Neste cenário, os ureteres se apresentam fora do seu local anatômico, sendo inseridos no útero, no colo da vesícula urinária, na uretra ou na vagina. Os sinais clínicos comumente apresentados são a incontinência urinária bem como a dermatite perivulvar. O tratamento de eleição para correção da anomalia é o procedimento cirúrgico, no qual a técnica de escolha é baseada na relocação do ureter ectópico e tratamento das alterações associadas. Neste contexto, o presente relato descreve um caso de ectopia ureteral bilateral intramural, corrigido cirurgicamente por meio da técnica neoureterocistostomia, o que possibilitou controle da incontinência urinária do paciente.(AU)

Neouretra com enxerto autógeno de segmento intestinal vascularizado em felino / Autogenous vascularized intestinal grafting for urethral reconstruction in feline

Background: Serious urethral damage or recurrent obstructions in felines require a urethrostomy to provide a return to and maintenance of urinary flow. In some cases, urethral reconstruction with complementary tissue is required. Grafting of autogenous vascularized intestinal segments is widely used in human medicine to promote the functional restoration of the urethra, but in veterinary medicine, its use is still incipient. Thus, the aim of this report was to analyze and describe the use of thein functional urethral repair in a feline diagnosed with a severe urethral rupture. Case: A castrated male cat presented with urethral obstruction. Emergency decompression cystocentesis was performed, and fluids and analgesics were administered. Catheterization and urohydropropulsion were attempted to relieve the obstruction, without success. An emergency perineal urethrostomy was indicated. After the procedure, the diagnosis (obstructive lower tract urinary disease) and the infeasibility of restoring urinary flow by conventional urethrostomy techniques were confirmed. We opted for a laparoscopic-assisted prepubic urethrostomy; the pre-prostatic urethra was transected, and its caudais end was brought through an abdominal incision cranially. However, urethral tension was noted after this maneuver was performed. Thus, we decided to use autogenous vascularized intestinal segment grafting for urethral reconstruction. A segment of the ileum was prepared for grafting, with preservation of irrigation and mesenteric innervation. A terminoterminal anastomosis was performed on the stumps of the remaining intestine, and the mesentery was sutured. The ileal graft was isolated and washed to remove...

Neouretra com enxerto autógeno de segmento intestinal vascularizado em felino / Autogenous vascularized intestinal grafting for urethral reconstruction in feline

Background: Serious urethral damage or recurrent obstructions in felines require a urethrostomy to provide a return to and maintenance of urinary flow. In some cases, urethral reconstruction with complementary tissue is required. Grafting of autogenous vascularized intestinal segments is widely used in human medicine to promote the functional restoration of the urethra, but in veterinary medicine, its use is still incipient. Thus, the aim of this report was to analyze and describe the use of thein functional urethral repair in a feline diagnosed with a severe urethral rupture. Case: A castrated male cat presented with urethral obstruction. Emergency decompression cystocentesis was performed, and fluids and analgesics were administered. Catheterization and urohydropropulsion were attempted to relieve the obstruction, without success. An emergency perineal urethrostomy was indicated. After the procedure, the diagnosis (obstructive lower tract urinary disease) and the infeasibility of restoring urinary flow by conventional urethrostomy techniques were confirmed. We opted for a laparoscopic-assisted prepubic urethrostomy; the pre-prostatic urethra was transected, and its caudais end was brought through an abdominal incision cranially. However, urethral tension was noted after this maneuver was performed. Thus, we decided to use autogenous vascularized intestinal segment grafting for urethral reconstruction. A segment of the ileum was prepared for grafting, with preservation of irrigation and mesenteric innervation. A terminoterminal anastomosis was performed on the stumps of the remaining intestine, and the mesentery was sutured. The ileal graft was isolated and washed to remove...(AU)

Cistostomia com sonda de Foley para desvio temporário do fluxo urinário em felino acometido por ruptura uretral iatrogênica / Cystostomy with Foley tube for temporary deviation of urinary flow in feline affected by iatrogenic urethral rupture / Cistostomía con tubo de Foley para la desviación temporal del flujo urinario en felino afectado por ruptura uretral iatrogénica

A ruptura uretral iatrogênica geralmente é uma intercorrência secundária à passagem forçada de sondas rígidas durante a tentativa de desobstrução uretral; procedimento este realizado como forma de eliminação imediata da urina em casos de retenção aguda. Pacientes obstruídos podem manifestar sinais de injúria renal aguda, sendo necessário o pronto restabelecimento do fluxo urinário. O presente estudo tem como objetivo demonstrar o uso de uma técnica de cistostomia temporária em felino com ruptura de uretra, feito a partir da inserção de uma sonda tipo Foley na região ventral da bexiga e fixação desta à parede abdominal para que a urina pudesse ser conduzida ao meio externo.

The iatrogenic urethral rupture is usually an intercurrence secondary to the forced passage of rigid tubes during the urethral clearance attempt; procedure that is performed as a means of immediate elimination of urine in cases of acute retention. Obstructed patients may show signs of acute kidney injury, requiring prompt restoration of urinary flow. The present study aims to demonstrate the use of a temporary cystostomy technique in feline with rupture of the urethra, made from the insertion of a Foley type probe in the ventral region of the bladder and fixation of it to the abdominal wall so that the urine could be conducted to the external environment.

La ruptura uretral iatrogénica suele ser una intercurrencia secundaria al paso forzado de tubos rígidos durante el intento de aclaramiento uretral; procedimiento que se realizó como un medio de eliminación inmediata de orina en casos de retención aguda. Los pacientes obstruidos pueden mostrar signos de lesión renal aguda, lo que requiere una pronta restauración del flujo urinario. El presente estudio tiene como objetivo demostrar el uso de una técnica de cistostomía temporal en felinos con ruptura de la uretra, realizada mediante la inserción de una sonda tipo Foley en la región ventral de la vejiga y su fijación a la pared abdominal para que la orina pueda ser conducida al ambiente externo.

Cistostomia com sonda de Foley para desvio temporário do fluxo urinário em felino acometido por ruptura uretral iatrogênica / Cystostomy with Foley tube for temporary deviation of urinary flow in feline affected by iatrogenic urethral rupture / Cistostomía con tubo de Foley para la desviación temporal del flujo urinario en felino afectado por ruptura uretral iatrogénica

A ruptura uretral iatrogênica geralmente é uma intercorrência secundária à passagem forçada de sondas rígidas durante a tentativa de desobstrução uretral; procedimento este realizado como forma de eliminação imediata da urina em casos de retenção aguda. Pacientes obstruídos podem manifestar sinais de injúria renal aguda, sendo necessário o pronto restabelecimento do fluxo urinário. O presente estudo tem como objetivo demonstrar o uso de uma técnica de cistostomia temporária em felino com ruptura de uretra, feito a partir da inserção de uma sonda tipo Foley na região ventral da bexiga e fixação desta à parede abdominal para que a urina pudesse ser conduzida ao meio externo.(AU)

The iatrogenic urethral rupture is usually an intercurrence secondary to the forced passage of rigid tubes during the urethral clearance attempt; procedure that is performed as a means of immediate elimination of urine in cases of acute retention. Obstructed patients may show signs of acute kidney injury, requiring prompt restoration of urinary flow. The present study aims to demonstrate the use of a temporary cystostomy technique in feline with rupture of the urethra, made from the insertion of a Foley type probe in the ventral region of the bladder and fixation of it to the abdominal wall so that the urine could be conducted to the external environment.(AU)

La ruptura uretral iatrogénica suele ser una intercurrencia secundaria al paso forzado de tubos rígidos durante el intento de aclaramiento uretral; procedimiento que se realizó como un medio de eliminación inmediata de orina en casos de retención aguda. Los pacientes obstruidos pueden mostrar signos de lesión renal aguda, lo que requiere una pronta restauración del flujo urinario. El presente estudio tiene como objetivo demostrar el uso de una técnica de cistostomía temporal en felinos con ruptura de la uretra, realizada mediante la inserción de una sonda tipo Foley en la región ventral de la vejiga y su fijación a la pared abdominal para que la orina pueda ser conducida al ambiente externo.(AU)

Obstrucción uretral en gatos / Urethral obstruction in cats / Obstrução uretral em gatos

A obstrução uretral é um quadro clínico emergencial, comumente observado em felinos, que pode resultar em sério comprometimento à sua saúde, como lesões renais agudas. Essa afecção pode ter causas mecânica, anatômica ou funcional, e apresentar como principais sintomas a estrangúria, periúria e lambedura excessiva da genitália. O diagnóstico é realizado com base no histórico, exame físico e de imagem, como ultrassonografia e radiografia, sendo a identificação da etiologia de suma importância para instituir o tratamento e diminuir os quadros de recidiva. Ao diagnosticar a doença, o início do tratamento deve ser imediato e intensivo, em virtude do risco de evoluir rapidamente para o óbito. Neste sentido, busca-se corrigir os distúrbios hidroeletrolíticos, fornecer analgesia e realizar a desobstrução uretral, havendo uma variação neste último procedimento, de modo que, a escolha do método mais indicado pode variar de acordo com cada caso. Com base na complexidade em seu estabelecimento, diagnóstico e tratamento, foi objetivado com esse artigo de revisão reunir informações atuais e relevantes, relacionadas ao quadro de obstrução uretral em gatos, procurando enfatizar aspectos clínico, cirúrgico e etiológico da doença, assim como, orientar médicos veterinários no tratamento e prevenção da mesma.

Urethral obstruction is an emergency clinical condition, commonly observed in cats, that can result in serious commitment of their health, such as acute kidney damage. This condition can have mechanical, anatomical or functional causes, presenting as main symptoms stanguria, periuria and excessive licking of genitals. The diagnosis is based on the history, physical and image exams, such as ultrasound and radiography, being the identification of etiology of great importance to institute the treatment and reduce recurrence. After diagnosing the disease, initiation of treatment needs to be immediate and intensive, because of the risk of evolving quickly to death. In this regard, it’s necessary to correct hydroelectric disturbances, provide analgesia and perform a urethral clearance, however there is a variation in this last procedure, so the choice of the most suitable method may vary according to each case. Based on the complexity of its establishment, diagnosis and treatment, this review aimed to gather current and relevant information related to urethral obstruction in cats, intending to emphasize clinical and etiological symptoms of the disease, as well as to guide veterinarians in its treatment and prevention.

La obstrucción uretral es una condición clínica de emergencia, comúnmente vista en gatos, que puede resultar en un deterioro grave de su salud, como daño renal agudo. Esta condición puede tener causas mecánicas, anatómicas o funcionales, y presentar extrañeza, periuria y lamido excesivo de los genitales como síntomas principales. El diagnóstico se realiza con base en la historia, examen físico y de imagen, como ecografía y radiografía, y la identificación de la etiología es de suma importancia para instituir el tratamiento y reducir la recurrencia. Al diagnosticar la enfermedad, el inicio del tratamiento debe ser inmediato e intensivo, debido al riesgo de evolucionar rápidamente a la muerte. En este sentido, buscamos corregir las alteraciones hidroelectrolíticas, aportar analgesia y realizar el aclaramiento uretral, con una variación en este último procedimiento, por lo que la elección del método más adecuado puede variar según cada caso. A partir de la complejidad de su establecimiento, diagnóstico y tratamiento, este artículo de revisión tuvo como objetivo recopilar información actual y relevante relacionada con la condición de obstrucción uretral en gatos, buscando enfatizar los aspectos clínicos, quirúrgicos y etiológicos de la enfermedad, así como orientar a los médicos veterinarios en su tratamiento y prevención.

Obstrucción uretral en gatos / Urethral obstruction in cats / Obstrução uretral em gatos

A obstrução uretral é um quadro clínico emergencial, comumente observado em felinos, que pode resultar em sério comprometimento à sua saúde, como lesões renais agudas. Essa afecção pode ter causas mecânica, anatômica ou funcional, e apresentar como principais sintomas a estrangúria, periúria e lambedura excessiva da genitália. O diagnóstico é realizado com base no histórico, exame físico e de imagem, como ultrassonografia e radiografia, sendo a identificação da etiologia de suma importância para instituir o tratamento e diminuir os quadros de recidiva. Ao diagnosticar a doença, o início do tratamento deve ser imediato e intensivo, em virtude do risco de evoluir rapidamente para o óbito. Neste sentido, busca-se corrigir os distúrbios hidroeletrolíticos, fornecer analgesia e realizar a desobstrução uretral, havendo uma variação neste último procedimento, de modo que, a escolha do método mais indicado pode variar de acordo com cada caso. Com base na complexidade em seu estabelecimento, diagnóstico e tratamento, foi objetivado com esse artigo de revisão reunir informações atuais e relevantes, relacionadas ao quadro de obstrução uretral em gatos, procurando enfatizar aspectos clínico, cirúrgico e etiológico da doença, assim como, orientar médicos veterinários no tratamento e prevenção da mesma.(AU)

Urethral obstruction is an emergency clinical condition, commonly observed in cats, that can result in serious commitment of their health, such as acute kidney damage. This condition can have mechanical, anatomical or functional causes, presenting as main symptoms stanguria, periuria and excessive licking of genitals. The diagnosis is based on the history, physical and image exams, such as ultrasound and radiography, being the identification of etiology of great importance to institute the treatment and reduce recurrence. After diagnosing the disease, initiation of treatment needs to be immediate and intensive, because of the risk of evolving quickly to death. In this regard, its necessary to correct hydroelectric disturbances, provide analgesia and perform a urethral clearance, however there is a variation in this last procedure, so the choice of the most suitable method may vary according to each case. Based on the complexity of its establishment, diagnosis and treatment, this review aimed to gather current and relevant information related to urethral obstruction in cats, intending to emphasize clinical and etiological symptoms of the disease, as well as to guide veterinarians in its treatment and prevention.(AU)

La obstrucción uretral es una condición clínica de emergencia, comúnmente vista en gatos, que puede resultar en un deterioro grave de su salud, como daño renal agudo. Esta condición puede tener causas mecánicas, anatómicas o funcionales, y presentar extrañeza, periuria y lamido excesivo de los genitales como síntomas principales. El diagnóstico se realiza con base en la historia, examen físico y de imagen, como ecografía y radiografía, y la identificación de la etiología es de suma importancia para instituir el tratamiento y reducir la recurrencia. Al diagnosticar la enfermedad, el inicio del tratamiento debe ser inmediato e intensivo, debido al riesgo de evolucionar rápidamente a la muerte. En este sentido, buscamos corregir las alteraciones hidroelectrolíticas, aportar analgesia y realizar el aclaramiento uretral, con una variación en este último procedimiento, por lo que la elección del método más adecuado puede variar según cada caso. A partir de la complejidad de su establecimiento, diagnóstico y tratamiento, este artículo de revisión tuvo como objetivo recopilar información actual y relevante relacionada con la condición de obstrucción uretral en gatos, buscando enfatizar los aspectos clínicos, quirúrgicos y etiológicos de la enfermedad, así como orientar a los médicos veterinarios en su tratamiento y prevención.(AU)

Chronic osteomyelitis in canine penile bone: case report / Osteomielite crônica em osso peniano canino: relato de caso

A 10-year-old male mixed-breed dog was admitted for recurrent signs of urinary tract infection (UTI). Urinary bladder ultrasonography revealed decreased thickness of its wall with floating hyperopic particles within its lumen. Ultrasonography revealed a structure invading the dorsal wall of the penile urethral lumen, located in a segment distal to the bladder. Radiographies showed bone resorption with proliferation at the caudal aspect of the penile bone, stricture of the final aspect of the penile urethra, and no radiopaque images compatible with a urethrolith. Computed tomography showed bone proliferation causing stricture of the urethral lumen at two different sites. Presumptive diagnosis of penile neoplasia was considered more likely and the dog underwent penectomy along with orchiectomy and scrotal urethrostomy. Enterobacter spp. was cultured from the urine sample and antibiotic sensitivity tests revealed that the bacterium was susceptible to amikacin, imipenem, and meropenem. Histopathology revealed severe suppurative urethritis, bone resorption, and hyperostosis, suggestive of osteomyelitis of the penile bone. Neoplastic cells were not observed at any part of the examined tissue. The findings in the present case suggest that osteomyelitis of the penile bone should be included in differential diagnosis for partial and complete urethral obstruction in dogs with recurrent UTI.(AU)

Um cão mestiço, com 10 anos, foi admitido por sinais recorrentes de infecção do trato urinário (ITU). A ultrassonografia da bexiga urinária revelou diminuição da espessura de sua parede com partículas flutuantes dentro de seu lúmen. A ultrassonografia demonstrou estrutura invadindo a parede dorsal do lúmen da uretra peniana, localizada em segmento distal à bexiga. Radiografias evidenciaram reabsorção óssea com proliferação no aspecto caudal do osso peniano, estenose do aspecto final da uretra peniana e ausência de imagens radiopacas compatíveis com uretrólito. Pela tomografia computadorizada, observou-se proliferação óssea causando estreitamento da luz uretral em dois locais diferentes. Diagnóstico presuntivo de neoplasia peniana foi considerado mais provável e o cão foi submetido à penectomia, juntamente com orquiectomia e uretrostomia escrotal. Enterobacter spp. foi cultivada da amostra de urina e testes de sensibilidade revelaram susceptibilidade ao amicacina, imipenem e ao meropenem. A histopatologia revelou uretrite supurativa grave, reabsorção óssea e hiperostose compatível com osteomielite do osso peniano. Células neoplásicas não foram observadas em nenhuma parte do tecido examinado. Os achados do presente caso sugerem que a osteomielite do osso peniano deve ser incluída no diagnóstico diferencial de obstrução uretral parcial e completa em cães com ITU recorrente.(AU)

Chronic osteomyelitis in canine penile bone: case report / Osteomielite crônica em osso peniano canino: relato de caso

A 10-year-old male mixed-breed dog was admitted for recurrent signs of urinary tract infection (UTI). Urinary bladder ultrasonography revealed decreased thickness of its wall with floating hyperopic particles within its lumen. Ultrasonography revealed a structure invading the dorsal wall of the penile urethral lumen, located in a segment distal to the bladder. Radiographies showed bone resorption with proliferation at the caudal aspect of the penile bone, stricture of the final aspect of the penile urethra, and no radiopaque images compatible with a urethrolith. Computed tomography showed bone proliferation causing stricture of the urethral lumen at two different sites. Presumptive diagnosis of penile neoplasia was considered more likely and the dog underwent penectomy along with orchiectomy and scrotal urethrostomy. Enterobacter spp. was cultured from the urine sample and antibiotic sensitivity tests revealed that the bacterium was susceptible to amikacin, imipenem, and meropenem. Histopathology revealed severe suppurative urethritis, bone resorption, and hyperostosis, suggestive of osteomyelitis of the penile bone. Neoplastic cells were not observed at any part of the examined tissue. The findings in the present case suggest that osteomyelitis of the penile bone should be included in differential diagnosis for partial and complete urethral obstruction in dogs with recurrent UTI.(AU)

Um cão mestiço, com 10 anos, foi admitido por sinais recorrentes de infecção do trato urinário (ITU). A ultrassonografia da bexiga urinária revelou diminuição da espessura de sua parede com partículas flutuantes dentro de seu lúmen. A ultrassonografia demonstrou estrutura invadindo a parede dorsal do lúmen da uretra peniana, localizada em segmento distal à bexiga. Radiografias evidenciaram reabsorção óssea com proliferação no aspecto caudal do osso peniano, estenose do aspecto final da uretra peniana e ausência de imagens radiopacas compatíveis com uretrólito. Pela tomografia computadorizada, observou-se proliferação óssea causando estreitamento da luz uretral em dois locais diferentes. Diagnóstico presuntivo de neoplasia peniana foi considerado mais provável e o cão foi submetido à penectomia, juntamente com orquiectomia e uretrostomia escrotal. Enterobacter spp. foi cultivada da amostra de urina e testes de sensibilidade revelaram susceptibilidade ao amicacina, imipenem e ao meropenem. A histopatologia revelou uretrite supurativa grave, reabsorção óssea e hiperostose compatível com osteomielite do osso peniano. Células neoplásicas não foram observadas em nenhuma parte do tecido examinado. Os achados do presente caso sugerem que a osteomielite do osso peniano deve ser incluída no diagnóstico diferencial de obstrução uretral parcial e completa em cães com ITU recorrente.(AU)